In Agnone, Italy, the day had been uncharacteristically warm for September in the mountains. After spending hours in the darkness of her father’s sick room, Maria Teresa blinked as she stepped into the light. Generous afternoon sun drew men into the square to play chess. The owner of the gelato shop cursed the good weather so late in the season when he had to leave the game thanks to school letting out. Further down the street, sixteen-year-old Vincenzo, Maria Teresa’s son, swept outside the candy shop, his apron streaked with cocoa. When a passing girl smiled at Vincenzo, he tipped his hat. An old woman, bracing her umbrella as though it was a cane, paused near Maria Teresa and straightened. Maria Teresa felt the nosy neighbor’s eyes searching her face for some sign as to Father’s well being.

“The weather’s beautiful,” Maria Teresa said, forcing a smile.

“Too beautiful,” the old woman replied. Her head shook slightly from side to side, a palsy Maria Teresa mistook for a gesture of discontent at first. The crone tapped her umbrella. “You watch, it will rain.”

Later, as Maria Teresa lay awake on a cot at the foot of Father’s bed, trying unsuccessfully to sleep, she could hear the storm start. Maria Teresa didn’t like the unpredictable rhythm of the first raindrops, the pauses where there was only silence and waiting. She wanted it to pour, unleashing a flood of steady sound.

Maria Teresa closed her eyes, trying to rest, but her thoughts turned to Leonardo, her first born, as they often did in the dark. His dimpled knuckles and padded wrists. The curl of his long lashes. The smell of her rosewater perfume in his hair. She’d held him constantly as a baby, snuggling him in a wrap close to her body when she needed her hands free for household chores. She’d considered him a part of her—the most beautiful, amazing part of her. Maria Teresa hadn’t thought anything of their closeness until some old women in the piazza had gestured towards her one-armed laundering and shamed her as only experienced mothers can.

“You’ll spoil him,” one woman had said.

“See there, he wants to walk,” another added. “Let him go.”

After that, Maria Teresa had been determined not to hold Leonardo. She started to wean him and to encourage him to explore and practice walking. But oh, how her little boy had mourned! She could still hear his high voice, begging to be carried, when she cooked. “Tu,” he’d say with his little pink finger in the air and she’d known he meant “su”—“up.” She would ignore him. Tell him to go play with his toys. Place him in the wooden baby chair on sliders that Manodoro made at her request. Sometimes, even scold him.

One day, when she had been called away from Villa Bianca to help with a birth, Leonardo followed her as she collected her instruments and medicine bottles. His arms were outstretched and dew-sized tears had glistened on his cheeks. He’d wanted to nurse.

“Mama, tu.”

She’d shooed him away—in part because she feared his fingers, sticky with jam, would soil her crisp midwife’s apron. But she’d also known that if she picked him up, she might never put him down again.

“Tu, Mama, tu.” He’d chased her from room to room, wailing and trying to grab her legs.

“Lasciami,” she’d finally said when his crying became unbearable.

Leave me.

And he had.

Later that day, while Maria Teresa helped birth a big-headed baby girl two towns away, he’d wandered with his wobbly gait away from Villa Bianca. When Manodoro looked up from preparing lunch, the back door was ajar and the boy was gone. Hours later, Manodoro had found Leonardo, floating, face down, in the creek behind their house. The boy’s blankie, dark with dirt, had washed up on a nearby bank days later. The drowning wasn’t Manodoro’s fault, Maria Teresa knew. Death was a relentless flirt. Many times, she’d turned her back on Leonardo in the kitchen, only to find him balancing on a chair or inches away from falling into the hot stove. The accident wasn’t God’s fault either—that’s what Don Giuseppe said. And Maria Teresa had to believe because, if she didn’t, a certain blackness would fill her soul. Mostly, Maria Teresa blamed herself. She loved the child into invincibility, never giving him a St. Joseph medal, or even a breve, because she foolishly thought her adoration was protection enough.

After the baby’s death, Maria Teresa hadn’t been able to leave the house, even for her midwife duties, for some time. An ache moved from one part of her body to the next, popping up with great violence then vanishing as quick as a summer storm. Her sadness was a sickness—a crippling, isolating disease. Her Mama, dead at thirty-seven-years-old from a cancer of the breast. Leonardo, just shy of seventeen months, drowned. Only her oldest and best friend, Bocca Grande, understood how these losses could accumulate over time, pulling you farther away from the living and closer to the dead. Bocca Grande had miscarried multiple times, and she’d confided in Maria Teresa that she once climbed the mountain to Lookout Point, intending to jump until a strange woman stopped her.

Thunder boomed. Maria Teresa opened her eyes.

“Cecilia,” Father whispered from his sick bed. “Water.”

Maria Teresa rose. For the past week, Maria Teresa had been wearing Mama’s old apron and cooking with Mama’s pots. At some point, she’d started answering to “Cecilia” as well, even though it meant corroborating Father’s delusional dreams fueled by a raging fever.

“Cecilia,” he said again, louder. “I need you.”

“I’m here,” Maria Teresa said.

She searched in the dark for the nightstand, bumping it first with her knee. Father had been parched lately, waking to drink several times in the night like an infant. When Maria Teresa finally found the pitcher, it was slick with sweat but empty. She couldn’t wake Vincenzo; he was still nursing a burn from a hot candy mould. Instead, she would have to go out into the storm herself and draw water from the ancient well behind the house in her night clothes. The idea made her shiver.

Maria Teresa felt about the nightstand. Her fingers located the water glass. Full, grazie Dio. She guided the cup to her father’s lips and he sipped slowly. Lightning blinked the room bright, and, in that second, Maria Teresa saw her seventy-year-old father clearly. He was more a baby than a man now. Bald head, spare eyebrows, and small, scared eyes. In his hand, he clutched a handkerchief with Mama’s initials sewn on the edge.

The wind wailed and picked at the lock on the shutters. Another clap of thunder unleashed a downpour. The gutters gurgled. Maria Teresa looked at the drinking glass, still in her hand. The water inside sloshed from side to side, small waves pulled by a strong, invisible force. At first, she thought that maybe her hand was trembling. Only later would she realize that it was the earthquake, causing the waves in the glass to grow bigger and bigger until the water breached the lip of the glass, spilling onto her sleeve where it mixed with tears.

Natalie Haney Tilghman co-authored A 52-HERTZ WHALE, Young Adult novel recently released by Carolrhoda Lab (Lerner). Honors include a 2015 Rona Jaffe Writer’s Award for this novel-in-progress and first prize for fiction in The Atlantic’s 2010 Student Writing Contest. She received a MFA from Rainier Writing Workshop. Her grandparents are from Abruzzo and she has dual citizenship in Italy